Provider Demographics
NPI:1497847602
Name:THOMAS, TIMOTHY LORIN (OT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:LORIN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-243-8153
Mailing Address - Fax:
Practice Address - Street 1:301 21ST AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1821
Practice Address - Country:US
Practice Address - Phone:615-329-6600
Practice Address - Fax:615-329-4858
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1584225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3656804Medicaid
TN3656804Medicaid